Binetti G, Mega M S, Magni E, Padovani A, Rozzini L, Bianchetti A, Trabucchi M, Cummings J L
Alzheimer's Disease Unit, Sacro Cuore Fatebenefratelli Hospital, Istituto di Ricerca e Cura a Carattere Scientifico, S. Giovanni di Dio, Brescia, Italy.
Arch Neurol. 1998 Apr;55(4):539-44. doi: 10.1001/archneur.55.4.539.
To compare 2 samples of patients with Alzheimer disease (AD), from Italy and the United States, in order to determine transcultural differences in the manifestation of noncognitive symptoms. To analyze the concurrent validity, internal consistency reliability, between-rater reliability, and test-retest reliability of the Neuropsychiatric Inventory Scale (NPI).
The NPI was given to 50 Italian and 50 US patients with AD. To demonstrate the validity and reliability of the Italian version of the instrument, several different methods of analysis were used. The total score on the NPI and the score of single items in the different stages of the disease were compared in the 2 samples of patients.
A high level of internal consistency reliability was confirmed, the between-rater reliability was very high, and the test-retest reliability was significantly correlated. Apathy was the most frequently recorded behavior in the Italian sample. Five of 10 NPI item scores showed a significant relation with the Mini-Mental State Examination scores in both samples. The Italian patients showed an increasing and significantly higher mean NPI total score at all levels of dementia severity when compared with the US patients. The scores on some NPI subscales, such as apathy, aberrant motor behavior, disinhibition, and agitation, were significant higher in Italian patients at different levels of severity covarying with educational level.
These results indicate that NPI is a reliable instrument with which to study transcultural differences in the presentation of neuropsychiatric disturbances in patients with AD. The described similar pattern of behaviors between Italians and US patients with AD suggests a biological origin of the disorders. However, cultural influences must be taken in account when the focus of the study is on psychopathological aspects of dementia.
比较来自意大利和美国的两组阿尔茨海默病（AD）患者样本，以确定非认知症状表现方面的跨文化差异。分析神经精神科问卷量表（NPI）的同时效度、内部一致性信度、评定者间信度和重测信度。
对50名意大利和50名美国AD患者进行NPI测评。为证明该量表意大利版本的效度和信度，采用了几种不同的分析方法。比较了两组患者样本中NPI的总分以及疾病不同阶段单个条目的得分。
证实了较高水平的内部一致性信度，评定者间信度非常高，且重测信度显著相关。冷漠是意大利样本中最常记录到的行为。在两个样本中，10个NPI条目得分中有5个与简易精神状态检查表得分显著相关。与美国患者相比，意大利患者在痴呆严重程度的所有水平上，其NPI总分均值均呈上升趋势且显著更高。在不同严重程度水平上，意大利患者在一些NPI子量表上的得分，如冷漠、异常运动行为、脱抑制和激越，与教育水平相关且显著更高。
这些结果表明，NPI是研究AD患者神经精神障碍表现的跨文化差异的可靠工具。所描述的意大利和美国AD患者之间相似的行为模式表明这些障碍具有生物学起源。然而，当研究重点是痴呆的精神病理学方面时，必须考虑文化影响。
